| Abstract: | 長期照顧服務產業的營運與管理—從居家服務組織的實踐經驗出發 摘要 近年來隨著人口的老化以及家庭結構的轉變，失能老人的照顧問題已經成為社會各界關注的焦點。政府部門也將失能老人的照顧問題列入施政的重點，各項方案也在陸續的推出中，近年來除了「照顧服務產業發展方案」以及「十年長期照顧計畫」之外，最近一項新的政策訊息就是政府預計在民國一百年開始實施長期照顧保險，希望透過保險的機制，來解決民眾長期照顧的問題。 其實不管是民間林立的安養中心，或者是民眾私人雇用的外籍監護工以及政府這些年所陸續推出的各項老人照顧方案等，它都與廣泛意義的長期照顧服務產業有關。所謂的長期照顧服務產業，它是一項因應人口高齡化所興起的服務性工作，需要倚靠大量的人力以及資本的投入，可以說是一項勞力密集以及資本密集的產業。本研究即是針對目前在台灣所推動的各項照顧服務產業，特別是在居家服務部份進行探討，希望透過學理的分析以及實證的研究，為將來我國照顧服務產業的營運與管理尋找出一種可行的模式出來。 本研究主要採取質性的研究方法，再輔以少數的問卷研究做量化分析，希望透過「質量並重」的方式，對影響長期照顧服務產業的各個面向進行分析。在質性研究部分，研究者針對我國長期照顧服務產業的政策利害關係人，包括中央經建會、內政部社會司以及衛生署的長期照護處等單位的首長、各地方政府的社政主管以及目前在各地方實際經營照顧服務產業的負責人等，進行深度訪談，請教他們對於整個長期照顧服務產業的觀點與想法；另外，則對於在第一線提供服務的照顧服務員以及接受服務的案家等，透過問卷的方式，蒐集他們對長期照顧服務產業的看法。經由這些訪談與問卷分析，讓我們對未來照顧服務產業的發展有更深入的了解。 研究發現若要做好照顧服務產業的營運與管理，則必須具備幾個因素。首先各營運機構一定要做好專業人才的培訓工作，以提升機構照顧管理的能力；其次，要發展照顧管理機制，以「全人」觀點照顧失能老人；第三，要做好服務品質的管控工作，以維持服務品質的穩定。此外，本研究也發現，關於長期照顧服務產業的營運和管理，也與未來的長期照顧政策有密切的相關性，尤其是引進外籍監護工和長期照顧保險的開辦與否等這兩項政策更是關係密切。我國的照顧服務產業如果要能持續的發展，勢必要檢討外籍監護工的引進政策，同時也應該要儘速開辦長期照顧保險，這樣一方面可以讓長期照顧體系有穩定的財源支撐，另一方面也可引進民間資源投入長期照顧市場，讓有需求的民眾有更多的選擇性。至於研究結論則作為政府將來規劃長期照顧服務產業的參考、實務操作、理論文獻思維等建議。關鍵字：長期照顧服務產業、政策利害關係人、外籍監護工、照顧服務員
Long term caring service industry operation and management – starting from the localization experienceAbstractRecent years with the accumulation of the aging population and changing family structure, disabled elderly people has become the most significant problem among the greater society. The government has acknowledged this issue and became one of the most important tasks in the agenda, and various projects are developing henceforth. Apart from the “Caring service industry development project” and “ten-year long-term caring project”, the latest government action is to start long-term caring insurance plan at the year of 2011, and it is anticipated that via insurance mechanism, to solve the long-term service issues raised by the general public. This study mainly adopts qualitative methodology, and with the aid of small amount of questionnaires to conduct quantitative analysis, it is expected to draw different dynamic results via both qualitative and quantitative methods, in order to generate useful outcome in terms of long term caring service industry. Formal depth interviews will be conducted with key personnel including the National long term caring industry planning group. The interview will be formal, structured, and opened to interviewee for their crucial input towards long term caring service industry. In addition, questionnaires will be given to front line care-workers and to those families receiving the service. With questionnaires, it is anticipated to collect their thoughts towards the long term caring service industry. Consequently, by combining the interview and questionnaire data for analysis, it is expected to gain beneficial and deeper understanding towards future planning of service oriented industry. This study found that in order to conduct proper service-oriented industry operation and management, certain key issues are required. Firstly, organizations should have their employees well-trained in order to increase the managing capability, and secondly, they should develop care management system to service the disabled elderly people. Thirdly, to take significant consideration on the quality aspect of service work (ServQ), in order to sustain and maintain the service quality level.The conclusion of the study is provided for future planning of long term caring industry as a reference, practical skills, and theoretical discussion only. Keywords: long term caring industry, policy stakeholder, foreign care-worker. Care-service worker |
